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1903, he wrote as follows:—'Since October, 1902, to the present time,
this standard has not been maintained, excepting for a period of three weeks
at the end of June and beginning of July, 1903. That is for over twelve
months out of the last thirteen, there has been more or less overcrowding
in the Scarlet Fever wards.' He also said in the same Report:—'The
continuous overcrowding has prevented a thorough cleansing of the Scarlet
Fever wards, and in conjunction with the overcrowding, this has in all
probability aggravated the condition of some of the patients, and notwithstanding
every care, led to a certain number of return cases.'
There is no legal power except in certain cases, to compel people to
enter a hospital when suffering from an infectious disease, but moral
persuasion is always used to urge them to do so on the rare occasions when
removal is objected to. It is therefore all the more necessary that the
Authorities should be in a position to guarantee the best possible treatment
in their Hospital. One of the most essential things is sufficient air space.
The patients chance of recovery is diminished directly his air space is
reduced below 2000 cubic feet, and the possibility of a patient being discharged
from Hospital apparently well, but not free from infection is greatly
increased when convalescent people are crowded together. Insufficient airspace
is therefore a danger both to the individual patient and also to the
community. In all Hospitals it may happen at certain times that a
temporary overcrowding is unavoidable, and that the air space has occasionally
to be reduced to 1500 cubic feet. This is even allowed by the Local
Government Board in exceptional times of stress, or where all the patients
are young children. At Mogden it was becoming a routine custom of necessity
to take in all cases, no matter what theavailable space, and for many months
no patient had his proper quantity ; it was generally 1500 cubic feet, and
sometimes less."
The question of the enlargement of the Hospital has been considered
at various times, but no practical steps whatever have been taken towards
having the work done during the year. It has been good fortune and not
good management that prevented a repetition of the overcrowding that occurred
in 1903, but it is certainly not wise to depend on similar fortune in the
future, and should the number of cases of infectious disease increase next
year, without sufficient accommodation having been provided, the Council
will not be able to avoid responsibility.